Chronic Obstructive Pulmonary Disease (COPD)


Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a condition that reduces your lung function and makes it hard to breathe. It includes both chronic bronchitis and emphysema and affects more than 13% of Nevadans over age 55.

Causes of COPD

COPD is most commonly caused by long-term exposure to lung irritants, and in rare cases, genetics. Respiratory infections can also lead to chronic bronchitis, which is a common form of COPD.

Risk factors

Risk factors for COPD include long-term exposure to pollutants such as chemicals in the home or workplace, secondhand smoke, radon exposure, dust, smog or other airborne particulates. Chronic illness such as colds which lead to respiratory infection can also be a risk factor, and in Nevada, those aged 55-64 are around twice as likely as those aged 45-54 to be diagnosed with the disease.

Airway obstructions

When a substance such as cigarette smoke is inhaled, it causes chronic inflammation in the lungs. This leads to airway obstruction that is similar to asthma, though unlike asthma it produces a daily, phlegm-producing cough. Over time, this leads to chronic bronchitis, emphysema and other damage to the lungs.

Cigarette smoke

Smoking is the most common cause of COPD and accounts for 85-90% of all cases in the US Smoking-related productivity losses such as those from COPD account for over $1 billion annually in the state of Nevada. While more than 12% of Nevada COPD sufferers are current or former smokers, less than 3% are not. Cigarette smoke contains over 7,000 chemicals, many of which are toxic. When inhaled, these toxins constrict airways and capillaries while slowly damaging the tiny air sacs in your lungs. Eventually, the damage becomes extensive enough that breathing becomes permanently difficult.

What is COPD care and management?

While there is no cure for COPD, its symptoms may be managed and its progression slowed with medications, pulmonary rehabilitation, supplemental oxygen or surgery. This includes managing symptoms of emphysema and chronic bronchitis, both being common forms of COPD. Asthma also has similar symptoms and often coincides along with COPD, and interstitial lung diseases such as sarcoidosis or pulmonary fibrosis can also cause scarring in the lungs that obstructs breathing over time.

COPD occurs in five stages, including:

  • Stage 0, which is considered “at risk.” During this stage, a chronic cough and mucous production are experienced, though lung function may otherwise be normal. While treatment isn’t necessary at this stage, it is recommended that you quit smoking, avoid air pollutants, exercise and eat a healthy diet to slow or avoid the progression of the disease.
  • Stage I, which is considered “mild.” While you may not be aware of lung disease at this stage without a diagnosis, there may be a chronic, productive cough. Your doctor will likely prescribe a short-acting bronchodilator to be used as needed.
  • Stage II, which is considered “moderate.” During this stage, you may begin to feel shortness of breath during exertion, and your doctor may prescribe a long-term bronchodilator along with pulmonary rehabilitation.
  • Stage III, which is considered “severe.” Flare-ups are more frequent at this stage, and increased shortness of breath will be experienced. Your doctor will probably add inhaled glucocorticosteroids along with long-term oxygen therapy and possibly antibiotics. Surgical treatment may also be considered at this time.
  • Stage IV, which is considered “very severe.” By this stage, symptoms continue to worsen and flare-ups may become deadly. Quality of life is severely impacted.

Due to the severity of this progressive disease, you need to see your doctor immediately upon symptoms such as a chronic cough, asthma or shortness of breath. Remember that the sooner it is diagnosed, the less chance you have of it becoming severe.

Symptoms of COPD

Symptoms of COPD may include frequent respiratory infections, low energy, and unexplained weight loss, and some symptoms may be mistaken for other conditions such as asthma. However, any symptoms should receive immediate attention since most don’t materialize until extensive lung damage has occurred.

This includes any persistent cough whether productive or not or any other breathing problems which may include:

  • Wheezing
  • Shortness of breath during routine activity
  • Chronic respiratory infections
  • Chronic, phlegm-producing cough
  • Fatigue
  • COPD exacerbation

What is COPD exacerbation?

An exacerbation is the worsening or “flare-up” of COPD symptoms. This is often caused by an infection in the lungs, though the cause is not always known. During an exacerbation, swelling and irritation of the lungs occurs which causes extreme illness in some cases, and may take longer than a month for recovery.

Prevention of COPD

As with most chronic diseases, prevention is key. This includes:

  • Not smoking–Tobacco smoke is the leading cause of COPD. If you smoke, quitting is your best defense, and even if you don’t smoke, second-hand smoke can put you at risk.
  • Avoid indoor pollutants–Indoor pollutants such as radon gas, second-hand smoke, and certain chemicals can cause worsening COPD symptoms. By ensuring your home is smoke-free and letting your doctor know about any contaminants you think may be causing you trouble, you can better keep your home safe from the dangers of COPD pollutants.
  • Avoid outdoor pollutants–If you live in an urban or another area high in airborne pollutants, you need to monitor air quality and avoid going out on bad air days, especially to exercise. Considerations should also be made when selecting a location to move to. Proximity to factories, busy roadways or other areas of high airborne contaminants should be avoided.
  • Prevent infections–Respiratory infections can become serious and lead to chronic bronchitis. If you are prone to colds and flu, you need to avoid crowds, wash your hands often, and get annual vaccinations during flu season.
  • Exercise–By getting around 30 minutes of moderate exercise five days per week, you can keep your lungs robust and healthy which greatly lowers your susceptibility to COPD.
  • Regular checkups–COPD symptoms may not appear until it’s too late, and regular checkups are critical to avoid permanent damage to your lungs.

Speak to Intermountain Health to learn more about COPD

With our award-winning network of over 300 primary care physicians and more than 1,700 specialists, Intermountain Health puts your care in the best of hands. This includes the convenience of multiple clinics and providers located throughout Southern Nevada so that you are never far from the best healthcare available. Whether you think you may be at-risk for COPD or you simply need a checkup or other medical services, making an appointment today is as easy as calling 702-852-9000, or you can visit our patient resources page to request an appointment.

Part of being well is being heard.